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Thursday, August 11, 2016

ObamaCare
in Abeyance- The Big Picture

Everybody knows ObamaCare is in a state of suspension.Nothing much is being said about it because
other issues -Hillary Clinton’semails,Donald Trump’s misstatements, the differing economic plans of the two –
have taken center stage.

But everybody knows ObamaCare’s future hinges on the
election.And everybody knows on
November 1, bigpremium increases
ranging from 10%to 50%,will be announced, and the fourth signup for
health exchanges begins.If not enough
of the young and healthy sign on,an
ObamaCare meltdown looms,and it will up
to the new President to clean up the mess and prevent a death spiral.

The
Nation’s Biggest Business

Why is ObamaCare reform so difficult?

In my opinion,the
main reason, is only partly ideological but
mostly because health care is the nation’s
biggest business, soon to consume 20% of the GNP and still relentlessly
expanding.Health care reform depends
on transforming am embedded system that has grown from 5% of GNP to where it is
today

In any given city,such as New York City,Boston, or
Minneapolis,or any given geographic region,health care is likely to be the single
biggest employer and the single biggest revenue center, outstripping manufacturing or service industries like finance.

Fiendishly
Complicated

Furthermore, health reform is “fiendishly complicated,”
pitting the government’s bureaucracy, which cannot go out of business, and CMS
against entrenched for-profit, medical industrial complex, that complicated
network of physicians,hospitals, drug
companies,chains of suppliers,nursing and rehabilitation facilities.

Lack of
Compromise

To complicate matters,a spirit of compromise is lacking between the forces of government and
the forces of commerce.President Obama
has mastered the art of executive actions,and the Congress has responded in kind with legal actions and political blockades.Much of the political conflict revolves around the U.S. Constitution , possibly the world’s best example of high
level compromise,and the Constitution’s
immutability, what the founders intended,and what flexibility and change is
possible .

Unanswered
Questions

Several reform questions remain unanswered.

Does ObamaCareincrease quality?

Do its countless regulations impair economic growth, or
cripple small business startups?

Does it contribute to exploding physician shortages?

Who should make decisions at the point of care – government or
clinicians?

Do government reforms, aimed at using data to determine”value,
”in part by herding doctors into integrated large groups and networks, making
them easier to control, work or simply make care impersonal and bureaucratic?

Do these reform spell the death knell of autonomous private
practice,or open the flood gates for
concierge and other forms of direct cash medicine?

Can consumers afford to keep their private physicians?

Will the present problems and the attendant frustrations
cause voters to throw up their hands in despair and opt for government –controlled
universal health care?

November
1 and Ensuing Three Months Will Rouse Sleeping Dogs

For now,these questions and the other issues of
health reform,are sleeping dogs in the
presidential campaign.Premiums
increases on November 1, the week before the election,and failure to sign up enough of the young
and healthy over the three months of the fourth exchange signup,will rouse the sleeping dogs.

The Health Reform Maze

Buy the Book

Book Description: In this first book in a series of four, Richard L. Reece, MD. provides a unique view of the roll out, and run up, of the Affordable Care Act. Reece shows in this book the progress and facets of ObamaCare's marketers and messengers, as the day approached for the launch of health insurance exchanges - the single most public and problematic portion of the new law. This is a must read for anyone who wants to chronicle this attempt to organize more than one-sixth of the U.S. economy by adding layers of federal government control and regulations.

Reece has been writing about U.S. health care for more than 45 years. His knowledge and experience, added to his keen intellect and gift of subtle humor, make this book a valuable part of anyone's collection.